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Fructose Consumption and Metabolic Dysregulation

NCT01445730 — Not applicable, Completed, 82 participants, Marja-Riitta Taskinen

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Fructose Consumption Aggravates Dysregulation of Postprandial Lipid Metabolism in Obese Hypertriglyceridemic Men With High Cardiometabolic Risk Profile and Associates With Liver Fat Deposition

RegistryNCT01445730
StatusCompleted
PhaseNot applicable
Study typeInterventional; na, single group, masking: none, basic science
Enrollment82 (Actual)
SponsorMarja-Riitta Taskinen (Other); collaborators: Sahlgrenska University Hospital, Lund University, University of Naples, Laval University
ConditionsCentral Obesity, Hypertriglyceridemia
InterventionsFructose (Dietary supplement)
Datesstart 2011-08-01, primary completion 2015-05-01, completion 2015-06-01, first posted 2011-10-04, last updated 2021-06-15
Locations4 sites in Canada, Finland, Italy, Sweden

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-Summary

High fructose intake is increasingly recognized as causative in development of prediabetes, metabolic syndrome and cardiovascular disease (CVD). The mechanisms underlying fructose-induced metabolic disturbances are unclear but are beginning to be unraveled. In contrast to metabolism of glucose, the breakdown of fructose leads to the generation of metabolites that stimulate hepatic de novo lipogenesis (DNL) and increased levels of both fasting and postprandial triglycerides. The key lipogenic transcription factor seems to be activated by fructose independently of insulin. However, it is still controversial whether fructose consumption increases DNL in man to the extent that it induces metabolic disturbances. Animal studies have shown that also the adipose tissue is responsive to fructose feeding fructose, and that high fructose-feeding induces insulin resistance and inflammation in the adipose tissue. The role of intestinal insulin resistance in fructose-induced dysmetabolism has not been studied in detail. The critical question is whether the metabolic disturbances are induced by calorie excess or by fructose per se.

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+Detailed description

Detailed description: Study subjects will participate to studies 1-4 before and 3 m after fructose diet:

1. An oral fat load or a kinetic study with stable isotopes combined with an oral fat load.
2. Determination of liver, subcutaneous and intra-abdominal fat. (Proton magnetic resonance spectroscopy )
3. Lipolytic enzymes, advanced lipid analysis, fat biopsies and genetic studies and gut microbiota profiling
4. Oral glucose tolerance test and analysis of incretins and inflammatory biomarkers.

+Arms and interventions

ArmTypeInterventionsDescription
After fructose feedingExperimentalDietary Supplement: FructoseAfter 3 month fructose diet 75 g/day
  • Fructose (Dietary supplement): 3 month fructose diet 75 g/day

+Outcome measures

Primary outcomes

  • TG Plasma AUC [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge: Triglycerides (TG) plasma Area Under Curve (AUC)
  • B48 Plasma AUC [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge: apolipoprotein (apo)B48 plasma Area Under Curve (AUC)
  • TG Plasma iAUC [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge:Triglycerides (TG) plasma incremental Area Under Curve (iAUC)

Secondary outcomes

  • DNL [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge: de novo lipogenesis (DNL)
  • ApoC-III [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge: Apolipoprotein C-III (ApoC-III)
  • β-OH Butyrate [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge: beta-OH butyrate (β-OH butyrate)
  • Liver Fat [Form the baseline (time point 1) to end of treatment at 3 months (time point 2)]: Before vs. after fructose challenge

+Eligibility

Sex: Male, ages: 20 Years to 60 Years, accepts healthy volunteers

Inclusion Criteria:

* Body mass index 27-40
* Waist > 96 cm
* Age 20-60 years
* Male

Exclusion Criteria:

* Smoking
* Active health problems
* Contraindications to MRI scanning
* Bleeding tendency
* Abnormal liver or renal function tests
* Type 2 diabetes
* Evidence of metabolic or viral liver disease
* Alcohol intake > 21 units per week
* Chronic medication except ones needed for stable hypertension

+Posted results

Participant flow

MilestoneAfter Fructose Feeding
Started82
Completed71
Not completed11

Outcome results

  • TG Plasma AUC (Primary), Mean, mmol/l*min: After Fructose Feeding 1130 +/- 590 (p 0.005)
  • B48 Plasma AUC (Primary), Mean, mg/l*min: After Fructose Feeding 7660 +/- 3210 (p 0.04)
  • TG Plasma iAUC (Primary), Mean, mmol/l*min: After Fructose Feeding 377 +/- 422 (p 0.04)
  • DNL (Secondary), Mean, μmol/L: After Fructose Feeding 12.3 +/- 10 (p 0.005)
  • ApoC-III (Secondary), Mean, mg/dL: After Fructose Feeding 10.4 +/- 5.1 (p 0.006)
  • β-OH Butyrate (Secondary), Mean, mg/dL: After Fructose Feeding 0.699 +/- 0.55 (p 0.01)
  • Liver Fat (Secondary), Mean, percentage of liver fat content: After Fructose Feeding 6.66 +/- 6.1 (p 0.008)

Adverse events

Time frame: During 3 month fructose diet 75 g/day.

ArmDeathsSerious adverse eventsOther adverse events
After Fructose Feeding0/82 (0.0%)0/82 (0.0%)1/82 (1.2%)

Other adverse events by term

TermOrgan systemAfter Fructose Feeding
skin rashSkin and subcutaneous tissue disorders1/82

+Locations (4)

FacilityCityCountryStatus
Université LavalQuébecCanada
Helsinki University Central Hospital, BiomedicumHelsinkiFinland
University of Naples, Federico II, and Faculty of MedicineNaplesItaly
Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University HospitalGothenburgSweden

+Publications

  • Results publication: Taskinen MR, Bjornson E, Matikainen N, Soderlund S, Ramo J, Ainola MM, Hakkarainen A, Sihlbom C, Thorsell A, Andersson L, Bergh PO, Henricsson M, Romeo S, Adiels M, Ripatti S, Laakso M, Packard CJ, Boren J. Postprandial metabolism of apolipoproteins B48, B100, C-III, and E in humans with APOC3 loss-of-function mutations. JCI Insight. 2022 Oct 10;7(19):e160607. doi: 10.1172/jci.insight.160607. PMID 36040803

+Study documents

+Investigators

My Notes